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目的比较旋磨术与切割球囊及常规球囊对冠状动脉支架内再狭窄的疗效。方法将416例单支冠状动脉病变支架内再狭窄患者分别用旋磨术、切割球囊与常规球囊进行扩张治疗,在治疗即刻及6个月时再次行冠状动脉造影并进行定量分析。结果(1)介入治疗前各组间支架内再狭窄情况无明显区别。(2)旋磨后即刻所获得的冠状动脉支架内最小血管直径(MLD)最大(2.67±0.55mm,P<0.05),切割球囊与常规球囊治疗组差异无统计学意义(2.51±0.65mm比2.53±0.65mm,P>0.05)。(3)6个月后旋磨治疗组的冠状动脉支架内MLD最小(1.52±0.91mm,P<0.05),切割球囊组大于常规球囊治疗组,但差异无统计学意义(1.96±0.74mm比1.75±0.83mm,P>0.05)。旋磨术与切割球囊及常规球囊治疗组支架内血管直径狭窄率分别为54.78%,38.31%及46.50%。(4)旋磨治疗组后期血管丢失量最大(P<0.05),切割球囊组明显低于常规球囊治疗组(P<0.05)。结论旋磨术对冠状动脉支架内再狭窄即刻疗效显著,但远期疗效仍以经皮腔内冠状动脉成形术(PTCA)最佳。
Objective To compare the curative effect of rotational atherectomy, cutting balloon and conventional balloon on coronary stent restenosis. Methods 416 cases of single coronary artery stenosis in patients with stent restenosis were rotational atherectomy, cutting balloon and conventional balloon dilation treatment, and at 6 months and again coronary angiography and quantitative analysis. Results (1) There was no significant difference in the restenosis between the groups before interventional treatment. (2) The minimum vessel diameter (MLD) of coronary stent obtained immediately after rotational atherectomy was the highest (2.67 ± 0.55mm, P <0.05), there was no significant difference between cutting balloon and conventional balloon therapy group (2.51 ± 0.65 mm ratio 2.53 ± 0.65mm, P> 0.05). (3) After 6 months, MLD was the smallest (1.52 ± 0.91mm, P <0.05) in coronary angioplasty group, but the difference was not significant in cutting balloon group (1.96 ± 0.74 mm ratio 1.75 ± 0.83mm, P> 0.05). Rotavillotomy and cutting balloon and conventional balloon therapy stent stenosis vessel diameter were 54.78%, 38.31% and 46.50%. (4) The rotational loss group had the largest amount of vascular loss at the later stage (P <0.05), and the balloon-cutting group was significantly lower than the conventional balloon therapy group (P <0.05). Conclusions Cyclotrocanteric surgery has significant curative effect on intracoronary restenosis, but the long-term efficacy is still the best by percutaneous transluminal coronary angioplasty (PTCA).